Peripheral retinal angioma with exudative retinopathy in adults (coats's lesion).

Coats, in his classic paper entitled "Forms of Retinal Disease with Massive Exudation", discussed three entities: (1) Cases without gross vascular disease of the retinal vessels.(2) Cases with gross vascular disease.(3) "A very peculiar group ... which is characterized by the formation of large arteriovenous com- munications."These cases are now considered to be identical with von Hippel's disease or retinal angiomatosis, and the two former groups are termed Coats's disease, types 1 and 2 respectively.Unfortunately, there exists a good deal of confusion about these two entities.Clinically, Coats's disease is rarely seen from its inception to its ultimate conclusion; it has been difficult to obtain early lesions for histological examination; and, finally, the pathogenesis of the disorder is still speculative.Most authorities agree about certain clinical features which may be of use in the diagnosis of this disease of unknown aetiology:Generally affects younger persons (20 per cent.older than 21 years).Males are more commonly involved than females.Usually unilateral (bilateral 10-15 per cent.).Usually no related systemic disorder.No early anterior segment ocular disease.Non-familial.The7ocular findings, particularly in early cases, are fairly specific: Type 1 Deep exudative mass generally at posterior pole.Usually a "woolly" or "flocculent" appearance.Yellow to greyish-green exudate.Exudate raised 1 5-4 5 D, always beneath retinal vessels.Glistening spots and areas suggestive of cholesterol.Concomitant retinal detachment.Retinal haemorrhages.Retinal vessels usually appear normal.